49 patients scheduled for 1- or 2-level lumbar fusion were randomized to postoperative analgesia with either patient-controlled epidural analgesia (EA group) or patient-controlled intravenous analgesia (PCA group). Patients were assessed for pain scores over the first 3 days postoperatively, length of hospital stay, and the incidence of adverse events. Pain scores on PODs 1, 2, and 3 were significantly lower in the EA group compared to the PCA group. The incidence of adverse events, including itching, nausea, vomiting, and hypotension did not significantly differ between groups.